Nursing Elites

1. A patient with bipolar disorder asks the nurse, "Why did I get this illness? I don't want to be sick."? The nurse would best respond with:

• A. People who develop mental illnesses often had a very traumatic childhood experience.
• B. There is some evidence that contracting a virus during childhood can lead to mental disorders.
• C. Sometimes people with mental illness have an overactive immune system.
• D. We don't fully understand the cause, but mental illnesses do seem to run in the family.

Correct answer: D

Rationale: The correct response is, 'We don't fully understand the cause, but mental illnesses do seem to run in the family.' Current research suggests that while genetics play a role in the development of mental illnesses like bipolar disorder, it is not the sole factor. Environmental influences, life experiences, and other non-genetic factors also contribute significantly to the manifestation of mental disorders. Choices A, B, and C provide incorrect information that is not supported by current research. Traumatic childhood experiences, contracting a virus during childhood, and an overactive immune system are not established causes of bipolar disorder or mental illnesses in general.

2. Plantar flexion can be prevented with ________________.

• A. foot soaks
• B. foot boards
• C. toenail care
• D. proper shoes

Correct answer: B

Rationale: Plantar flexion, or foot drop, can be prevented with foot boards, special splints, and range of motion exercises. Foot boards help maintain the foot in a neutral position, preventing contractures and deformities. Foot soaks (choice A) may help with foot hygiene but do not directly prevent plantar flexion. Toenail care (choice C) is important for overall foot health but does not prevent plantar flexion. Proper shoes (choice D) are essential for foot support and comfort but do not specifically prevent plantar flexion.

3. Which of the following is an example of whistle-blowing?

• A. A nurse contacts administration about a colleague who takes supplies to use for a mission trip
• B. A client sues a nurse because she failed to call the physician about his wound infection
• C. A nursing assistant calls for help when a client falls out of bed
• D. A client developed a sacral pressure ulcer when he was not turned in bed for over four hours

Correct answer: A

Rationale: Whistle-blowing involves notifying administration or a supervisor about unethical or illegal activities. In this scenario, the nurse reporting a colleague taking supplies for personal use is an example of whistle-blowing as it involves reporting behavior that is dishonest and potentially harmful. Choices B, C, and D do not represent whistle-blowing. Choice B involves a legal action by a client against a nurse, choice C is a situation where immediate care is provided, and choice D is a case of neglect that should have been prevented.

4. A client asks a nurse, 'Do you think I should move back home after this procedure?' and the nurse responds by saying, 'Do you think you should move back home?' What type of therapeutic communication is the nurse representing?

• A. Observation
• B. Reflection
• C. Summarizing
• D. Validating

Correct answer: B

Rationale: The nurse is demonstrating the therapeutic communication technique of reflection. In this scenario, the nurse is redirecting the question back to the client, encouraging them to explore their thoughts and feelings about the situation. Reflection involves restating a statement or question in a way that prompts the client to consider their own answers, fostering self-awareness and insight. Observation involves stating facts, summarizing involves condensing information, and validating involves confirming the client's feelings or experiences, none of which are demonstrated in this interaction.

5. A family member is complaining that the lights are too dim in the middle of the night when she comes in to visit her husband. What is the most objective response?

• A. Patients sleep better with the lights dimmed.
• B. The nightshift nurses prefer to work with less light.
• C. It's time for him to sleep, and you should, too.
• D. There's a reason we do that. Let me share a research study with you.

Correct answer: D

Rationale: The most objective response in this situation is to explain to the family member that there is a specific reason for dimming the lights and offer to share a research study to provide evidence-based information. By doing so, it helps the family member understand that the care provided is based on established practices and research, potentially alleviating her concerns and ensuring that her husband receives appropriate care. Choices A, B, and C do not address the family member's concern or provide a rationale backed by evidence, making them less suitable responses in this context.

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